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Type: Artigo
Title: Clinical Implications Of The Detection Of Antibodies Directed Against Domain 1 Of Beta 2-glycoprotein 1 In Thrombotic Antiphospholipid Syndrome
Author: Montalvao
Silmara; Elidio
Priscila Soares; Saraiva
Sabrina da Silva; Mazetto
Bruna de Moraes; Colella
Marina Pereira; de Paula
Erich Vinicius; Appenzeller
Simone; Annichino-Bizzacchi
Joyce; Orsi
Fernanda Andrade
Abstract: Antibodies directed against domain 1 of beta 2 glycoprotein 1 (a beta 2GP1-Dm1) have been involved in the immunopathogenesis of antiphospholipid syndrome (APS). However, the clinical relevance of a beta 2GP1-Dm1 in thrombotic APS has not yet been fully explored. Objectives: To determine the frequency of a beta 2GP1-Dm1 in a cohort of patients with thrombotic APS, and to evaluate whether testing for a beta 2GP1-Dm1 could have a clinical impact upon the risk assessment of the disease. Methods: Patients were tested for a beta 2GP1-Dm1 antibodies by chemiluminescence (BioFlash/AcuStar (R), ES). The presence of a beta 2GP1-Dm1 was evaluated in different clinical presentations of the disease. Results: Eight-four patients with a history of venous or arterial thrombosis were included. Forty-five (54%) patients had a beta 2GP1 antibodies and 40% of them were positive for a beta 2GP1-Dm1. Levels of a beta 2GP1-Dm1 were higher in patients with systemic autoimmune disease (AUC=0.665; 95% CI=0.544-0.786; P=0.01), positive antinuclear antibody (AUC=0.654; 95% CI=0.535-0.772; P=0.01), triple antiphospholipid antibody (aPL) positivity (AUC=0.680; 95% CI=0.534-0.825; P=0.02) and positive lupus anticoagulant (AUC=0.639; 95% CI=0.502-0.776; P=0.07). In this cohort, a beta 2GP1-Dm1 antibodies were not associated with the site of the first thrombosis (OR=0,62, 95% CI=0.20-1.94, P=0.42), thrombosis recurrence (OR=1.0, 95% CI=0.37-2.71, P=1.0) or pregnancy morbidity (OR=1.5, 95% CI=0.33-7.34, P=0.58). Inmultivariate analysis, positivity for a beta 2GP1-Dm1 antibodies was associated with the diagnosis of systemic autoimmune disease (OR=4.01, 95% CI=1.14-14.2; P=0.03) and triple aPL positivity (OR=3.59, 95% CI=0.87-14.85; P=0.07). Conclusions: In the present cohort of thrombotic-APS patients, a beta 2GP1-Dm1 antibodies were related to the diagnosis of systemic autoimmunity and complex serological profile of the disease, as triple aPL positivity and positive antinuclear antibody. Thus, our results suggest that testing for a beta 2GP1-Dm1 antibodies may be useful for improving APS risk assessment. (C) 2016 Elsevier Ltd. All rights reserved.
Subject: Antiphospholipid
Domain 1
Editor: Pergamon-Elsevier Science LTD
Rights: fechado
Identifier DOI: 10.1016/j.thromres.2016.10.001
Date Issue: 2016
Appears in Collections:Unicamp - Artigos e Outros Documentos

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